| NPI | 1730788761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: UT 9798092-4405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 9798092-4405) |
| Enumeration Date | 2020-10-21 |
| Last Update Date | 2025-01-21 |